Follow-up of Brain Aneurysms treated with GDC coils after 6 years Finitsis S, Bracard S, Anxionnat R, Picard Luc Service de Neuroradiologie Diagnostique.

Slides:

Advertisements

Similar presentations

Endovascular Treatment of Acute Aortic Emergencies: Early Results Badr Aljabri, MD, FRCSC King Khalid University Hospital Riyadh, Saudi Arabia.

Advertisements

Cerebrovascular disease of Brain CT

Advances in Interventional Neuroradiology Dr James F Peerless March 2014.

Vascular Diseases Re-written by: Daniel Habashi Seminar by: Dr. Jezewski.

عنوان کنفراس : کنفرانس سه روزه بیماری های عروق مغزی سالن همایش بیمارستان شهید رجائی دکتر سید رضا مجابی متخصص رادیولوژی عنوان سخنرانی : اپروچ های اندوواسکولر.

LAUREN SINNENBERG BS, WILSON SZETO, MD, PATRICK MOELLER BS, PRASHANTH VALLABHAJOSYULA, MD, G. WILLIAM MOSER, CRNP, NIMESH DESAI, MD PHD, JOSEPH BAVARIA,

BASILAR ANEURYSM DOES THIS CASE NEED FURTHER MANAGEMENT ? IF SO, WHAT IS BETTER; OPEN SURGERY &CLIPPING OR AGAIN ENDOVASCULAR COILING ?

Joseph Gastala, MD and Bruno Policeni, MD University of Iowa Hospitals and Clinics DISTRIBUTION OF SUBARACHNOID HEMORRHAGE WITH RESPECT TO THE FORAMEN.

Endovascular treatment on tandem lesions of cranial arteries Xiao-Long Zhang, MD, PhD Department of Radiology Huashan Hospital,Fudan University Shanghai.

Department of Neurosurgery, Changhai Hospital, SMMU

Duke Case Review. Patient’s History HPI: 52 year old woman presents with two weeks of diplopia and headache. Physical exam: Left partial sixth nerve palsy.

Charles Henderson. Purpose To occlude the aneurysm sac in an attempt to preserve the parent artery. A brain aneurysm, also called a cerebral or intracranial.

Which factor increases procedural thromboembolic events in patients with unruptured paraclinoid internal carotid artery aneurysm treated by coil embolization?

Y-STENTING ASSISTED EMBOLIZATION OF WIDE NECK ANEURYSMS USING FULLY RETRIEVABLE AND DETACHABLE INTRACRANIAL STENT SOBRI MUDA 1, RAZALI RALIB 2, YAZMIN.

T. Nakazawa, Y. Takeichi *, T. Yokoi, T. Fukami, J. Jito, N. Nitta, K. Takagi, K. Nozaki Shiga University of Medical Science, Department of Neurosurgery;

Aneurysmal Rupture during Embolization with Guglielmi Detachable Coils: Causes, Management and Outcome Dae Hyun Hwang M.D.,PhD.,YoungHwan Ko M.D., Kook.

Risk factors for Complications In Ruptured Aneurysms Embolization Clarity Study : 782 Patients L. Pierot, C. Cognard, R. Anxionnat, F. Ricolfi, et investigateurs.

H.Ghanaati; M.D. Associate Professor of Radiology Tehran University Of Medical Sciences Outcomes of intracranial aneurysms treated with coils: A six-month.

Department of Neuroendovascular Therapy, Kohnan Hospital, Sendai, Japan Ryushi Kondo, Yasushi Matsumoto Department of Neurosurgery, Kohnan Hospital Satoru.

"De Novo" Aneurysms: Radiologic and Clinical Analysis of Our Eleven Years Experience G. Di Lella, S. Gaudino, P. Colelli, M. Rollo, B. Tirpakova*, C. Colosimo.

XIX Symposium Neuroradiologicum Bologna,Italy 4-9 october 2010 Endovascular treatment of 50 posterior communicating artery aneurysms: overall, perioperative.

Spontaneous Dilatation of Stents at Three Months after Carotid Artery Stenting without post-CAS Balloon Dilatation YUHEI TANNO, Takahisa Mori, Tomonori.

Silk arterial reconstruction for intracranial aneurysms. Multicentric french study on 51 consecutive patients. Jérôme Berge, Alain Bonafé, Hervé Brunel,

Follow-up of patients after aneurysm embolotherapy with coils L Pyysalo,, L Keski-Nisula, T Niskakangas, V Kahara, J Öhman Tampere University Hospital,

Radiology Training Course. Timing of Imaging Studies.

UNIVERSITY OF KENTUCKY Department of Radiology. HPI  57 yo man presented to the ER with sudden onset severe chest pain.  On arrival, patient was pale,

Purpose: The purpose of this study is to investigate the treatment results, and procedure-related complications of stent-angioplasty for symptomatic intracranial.

O Mansour, J Weber and M Schumacher Neuroradiology Depart. Freiburg Univ. Neurology Depart. Alexandria Univ. Department of Neuroradiology, Neurocenter.

Cigarette Smoking Increases the Risk Of Formation and Rupture of Intracranial Aneurysms Shelebra Bartley Master’s Project Dr. Grimes.

Sandra Ferns, on behalf of the LOTUS study group

Double lumen remodeling balloon: New technique for treatment of MCA bifurcation aneurysm Kadziolka K, Leautaud A., Estrade L., W. Mustafa, Pierot L. CHU.

Carotid cavernous fistula: an easily missed

FIGURE 1. Illustration of the retractable, self-expandable Enterprise stent (Cordis, Miami Lakes, FL). From: PRELIMINARY EXPERIENCE WITH THE ENTERPRISE.

Endovascular Management of Pediatric Aneurysms- Focus on Outcomes

Single center experience with flow diverters

Contemporary Management of Splanchnic and Renal Artery Aneurysms: Results of Endovascular Compared with Open Surgery from Two European Vascular Centers

Cerebral aneurysm-single center experience

XIX SYMPOSIUM NEURORADIOLOGICUM W. Casagrande MD, S. Garbugino MD

Long-term review of selected basilar-tip aneurysm endovascular techniques in a single institution Mardjono Tjahjadi, MD, Tackeun Kim, MD, Devendra Ojar,

The Natural History of Cerebral Aneurysms

Unruptured Aneurysms Pipeline Onyx Coils Jawad F. Kirmani, MD.

Neurofibromatosis-associated massive right internal carotid artery aneurysm with a coexisting arteriovenous fistula Marlin Wayne Causey, MD, Daniel M.

Stent-assisted treatment of ruptured intracranial aneurysms in the acute phase: A single center experience Michael J. Ho, Sophia L. Göricke, Petra Mummel,

Management of unruptured intracranial aneurysm

Medical and Surgical Management of Intracranial Aneurysms

Ruptured PICA aneurysm in a 62-year-old man presenting in poor clinical condition. Ruptured PICA aneurysm in a 62-year-old man presenting in poor clinical.

A 39-year-old man with Hunt-Hess grade 1 subarachnoid hemorrhage

A 46-year-old female with a giant left internal carotid artery carotid–ophthalmic aneurysm symptomatic with headaches and left eye vision impairment. A.

A, Left internal carotid artery (ICA) angiogram showing a left middle cerebral artery (MCA) bifurcation aneurysm and an additional distal MCA aneurysm.B.

A 38-year-old man with ruptured basilar tip aneurysm with late regrowth and recurrent hemorrhage. A 38-year-old man with ruptured basilar tip aneurysm.

A, Patient 8: right carotid DSA shows a carotid bifurcation aneurysm, partially recanalized due to coil compaction after coil-only embolization 6 months.

Ruth L Bush, MD, Julian E Hurt, MD, Charles C Bianco, MD

Angiogram acquired at the end of endovascular treatment (A) and coronal multiplanar reformatting from bolus enhanced CT angiography (B), showing two overlapping.

Examples of three aneurysms treated with coil embolization except for the ophthalmic aneurysm (C) that was treated with stent assistance. Examples of three.

Giant serpentine aneurysm of the P2A segment of the PCA presenting with intracerebral and subarachnoid hemorrhage in a 12-year-old boy. Giant serpentine.

Endovascular treatment was performed approximately 8 months after the patient’s initial diagnosis. Endovascular treatment was performed approximately 8.

Case 2.A, Right internal carotid artery (ICA) angiogram, oblique view, showing a 4-mm aneurysm at the right middle cerebral artery (MCA) bifurcation.B,

Images from the case of a 78-year-old woman who presented with symptoms of a subarachnoid hemorrhage.A, Left internal carotid artery injection in the anterolateral.

A 70-year-old man with subarachnoid hemorrhage centered in the prepontine cistern (A). A 70-year-old man with subarachnoid hemorrhage centered in the prepontine.

A 29-year-old man with sudden neck pain followed by right-sided muscle weakness and difficulty in swallowing. A 29-year-old man with sudden neck pain followed.

Results of aneurysm treatment with flow modification only.

Non-contrast head CT (A) showing diffuse subarachnoid hemorrhage and hydrocephalus. Non-contrast head CT (A) showing diffuse subarachnoid hemorrhage and.

Patient with a 6-mm aneurysm of the AcomA that was treated with GDCs

Case 10.A, Left vertebral angiography obtained 6 months after previous surgery shows residual filling of the basilar tip aneurysm and additional right.

A 10-year-old boy with symptoms of brain stem compression from a giant partially thrombosed distal vertebral aneurysm. A 10-year-old boy with symptoms.

62-year-old woman (patient 5, Table 1) with sudden left-sided ptosis.

Giant infrasupraclinoid aneurysm of the right ICA

A 48-year-old woman presenting with a subarachnoid hemorrhage.

Procedural and follow-up angiograms of a 28-year-old female patient with a history of subarachnoid hemorrhage due to rupture of a contralateral MCA bifurcation.

A 71-year-old female with multiple large intracranial aneurysms.

Presentation transcript:

Follow-up of Brain Aneurysms treated with GDC coils after 6 years Finitsis S, Bracard S, Anxionnat R, Picard Luc Service de Neuroradiologie Diagnostique et Therapeutique Nancy, France

 Since 1992, prospective, single center, consecutive registry  The study included all patients treated up to 31/12/1998  Goal: patient population with a long-term follow-up of at least 6 years.

Methods  From 1992 until the end of 1998: 505 patients  89 patients fulfilled the criteria  Mean time of follow-up: 10,2 years sd. 2,1 years  Embolization with GDCs.  No use of balloon remodelling or stent

Patients  Mean age at the time of treatment: 44,7y (19 to 74 years)  67,4% females (60/89)  70% Single aneurysm (63/89)  30% Multiple aneurysms (2 to 4)  Total of 125 aneurysms  106 embolized with GDCs  12 followed  7 operated

Acom34%36/106 MCA21,7%23/106 Pcom18,8%20/106 Carotido-ophthalmic9%9/106 ICA bifurcation1,9%2/106 Pericallosal0,9%1/106 Choroidal0,9%1/106 Basilar tip5,7%6/106 Pica2,8%3/106 Vertebral2,8%3/106 SCA0,9%1/106 P20,9%1/106 Aneurysm Location

Subarachnoid Hemorrage 67,9%72/106 Fortuitous 27,4%29/106 Neurological Symptoms 4,7%5/106 Symptoms

Raymond Class Percentage Complete obliteration (I) 43,4%46/106 Neck remnant (II) 49,1%52/106 Partial filling (III) 7,5%8/106 Initial treatment results

Recurrences n Minor 5 Major 7 Further obliteration 5 5-years follow-up  During the 5 initial follow-up years:  16 patients had a 2 nd treatment  3 patients had a 3 rd treatment  1 patient was operated

6-years and longer (mean 10,1 y)  8 major recurrences occurred  7,5% of aneurysms (8/106)  Location  3 Acom  2 MCA  1 Basilar tip  2 Vertebral artery  Management  1 follow-up  6 embolization  1 surgery

Correlations  Partial obliteration at 5 years (p<0,001)  2 or more retreatment sessions during the initial 5 years (p<0.001)  Vertebral artery location (p=0,015)  No recurrence occurred when the obliteration was complete at 5 year follow-up.  No correlation with initial symptoms (p=0,5), sex (p=0,8), age (p=0,4), multiplicity of aneurysms (p=0,8)

Conclusions  Reccurences after 6 years occurred in 7,5% (8/106) of aneurysms (mean follow-up of 10,1 years)  Correlated with:  a partial result at 5 years  2 or more retreatment sessions during the initial 5 years  vertebral artery location  No recurrence occurred when the obliteration was complete at 5 year follow-up.